Sit-to-walk performance in Parkinson's disease: A comparison between faller and non-faller patients

Chiara Palmisano; Gregor Brandt; Nicoló Gabriele Pozzi; Alice Leporini; Virginia Maltese; Andrea Canessa; Jens Volkmann; Gianni Pezzoli; Carlo Albino Frigo; Ioannis Ugo Isaias

doi:10.1016/j.clinbiomech.2019.03.002

Sit-to-walk performance in Parkinson's disease: A comparison between faller and non-faller patients

Clin Biomech (Bristol, Avon). 2019 Mar:63:140-146. doi: 10.1016/j.clinbiomech.2019.03.002. Epub 2019 Mar 5.

Affiliations

¹ Department of Neurology, University Hospital and Julius-Maximilian-University, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; Department of Electronic, Information and Bioengineering, MBMC Lab, Politecnico di Milano, via Colombo 40, 20133 Milan, Italy.
² Department of Neurology, University Hospital and Julius-Maximilian-University, Josef-Schneider-Str. 11, 97080 Würzburg, Germany.
³ Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, via all'Opera Pia 13a, 16145 Genoa, Italy; Fondazione Europea di Ricerca Biomedica (FERB Onlus), Via Uboldo 18, 20063 Cernusco s/N, Milan, Italy.
⁴ Centro Parkinson ASST G. Pini-CTO, via Bignami 1, 20126 Milan, Italy.
⁵ Department of Electronic, Information and Bioengineering, MBMC Lab, Politecnico di Milano, via Colombo 40, 20133 Milan, Italy.
⁶ Department of Neurology, University Hospital and Julius-Maximilian-University, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; Centro Parkinson ASST G. Pini-CTO, via Bignami 1, 20126 Milan, Italy. Electronic address: Isaias_I@ukw.de.

PMID: 30889433
DOI: 10.1016/j.clinbiomech.2019.03.002

Abstract

Background: Falls are one of the main concerns in people with Parkinson's disease, leading to poor quality of life and increased mortality. The sit-to-walk movement is the most frequent postural transition task during daily life and is highly demanding in terms of balance maintenance and muscular strength.

Methods: With the aim of identifying biomechanical variables of high risk of falling, we investigated the sit-to-walk task performed by 9 Parkinson's disease patients with at least one fall episode in the six months preceding this study, 15 Parkinson's disease patients without previous falls, and 20 healthy controls. Motor performance was evaluated with an optoelectronic system and two dynamometric force plates after overnight suspension of all dopaminergic drugs and one hour after consumption of a standard dose of levodopa/benserazide.

Findings: Poor trunk movements critically influenced the execution of the sit-to-walk movement in patients with a history of falling. The peak velocity of the trunk in the anterior-posterior direction discriminated faller from non-faller patients, with high specificity and sensitivity in both the medication-off and -on state.

Interpretation: Our results confirm the difficulties in merging consecutive motor tasks in patients with Parkinson's disease. Trunk movements during the sit-to-walk can provide valuable measurements to monitor and possibly predict the risk of falling.

Keywords: Falls; Parkinson's disease; Sit-to-walk; Timed up and go; Trunk movement.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls / prevention & control*
Aged
Aged, 80 and over
Benserazide / administration & dosage
Case-Control Studies
Drug Combinations
Female
Humans
Levodopa / administration & dosage
Male
Middle Aged
Movement
Parkinson Disease / physiopathology*
Postural Balance*
Quality of Life
Sensitivity and Specificity
Sitting Position*
Walking*

Substances

Drug Combinations
benserazide, levodopa drug combination
Levodopa
Benserazide